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Dr Ebun Ladipo Bamgboye

Hello, am Dr. Ebun Bamgboye, Consultant Physician and Nephrologist, with a special interest in Nephrology (kidney medicine). I am also the head of the Dialysis/Transplant Unit at St. Nicholas hospital and the Clinical Director of the Hospital.

Dear Dr Bamgboye, let me first thank you for taking time out to be on Meet The Guru.

1. Saint Nicholas is the first hospital to carry out Renal transplant in Nigeria. How would you describe the "Renal transplant landscape" now in Nigeria?

2. 16 years and over 150 Renal transplants later, what would you say are the key lessons?

3. The role of Government in healthcare includes direct provision through public health Institutions and creating an enabling environment for both public and private hospitals such as Saint Nicholas Hospital. In what ways can Government increase access of Nigerians to Renal Replacement therapy?

4. Apart from a patients wish or desire, what are the possible reasons a doctor can and should refer a patient for renal transplant outside Nigeria?

The first transplant in Nigeria and indeed the whole of the sub-region was carried out at SNH 6/3/2000.
Since then over 10 other units in various parts of Nigeria have also carried out successful renal transplants.
As at the last count, SNH have done 156 transplants, BUK have done about 30 transplants, OAU ile Ife about 15, LUTH 8, UCH 3, GH Garki Abuja 8, UITH Ilorin 1, UMTH Maiduguri 1, DELSUTH Ogarra 4 or 5, LASUTH Lagos 1 and Zenith medical centre in Abuja about 20.
In conclusion, there are many centres now all around the country that have developed the capacity to carry out successful transplants and there really should not be a reason for individuals to travel out of the country for routine renal transplants.

The Key lessons after over 155 transplants, include the fact that with the right motivation and determination most things are possible here in Nigeria. There are always ways around a number of the challenges and vagaries one is certain to encounter along the way if one is determined to succeed. The average Nigerian is very intelligent and has been well trained and if determined and adequately supported can ensure that a lot of the medical tourism now responsible for a lot of capital flight out of the country can be avoided.

This is the main problem many of the centres in public hospitals are facing currently and why they have major challenges with sustaining successful transplant programmes. Most of these challenges are administrative in nature and given the right support from the authorities of these institutions their numbers and outcomes would certainly improve.

As regards why some patient's may still have to travel abroad, there are potentially a number of these.
The commonest reason we have found unfortunately are those patients who have presented donors that were evidently not altruistic and are commercial donors that have been rejected by the unit. Many travel with these same donors particularly to India and Pakistan where this commercial an unethical transplants are carried out by these units. There are also many complicated cases involving patients that have complex urologic defects or are super-sensitized and require various desensitization protocols not available currently in the country. Transplants are also in many such centres abroad being done across blood group barriers and this is potentially another reason why with the attendant De-sensitization protocols available in such centres why some individuals may choose to travel abroad for their transplants.

The average cost of an uncomplicated transplant now in Nigeria is about 6 million naira.

My advise the young up and coming doctors is for them to believe in themselves. Many of our younger colleagues trained locally and who have had the opportunity to travel and practice abroad have found they have fit seamlessly into the medical system in various countries around the world. Not all should however attempt to travel abroad as the local residency training programmes are available for them to avail themselves of. With the right determination (and less focus particularly during training on pecuniary concerns) the sky is the limit